If you have been reading about neurotrophic factor and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Last reviewed on 2025-10-11. Where a claim depends on a specific study, the study is described rather than over-claimed.
Development took place during the 1980s at institutes of the Russian Academy of Sciences, where peptide fragments of ACTH were screened for cognitive and neuroprotective effects. The compound received regulatory approval in Russia as a nasal preparation, marketed for conditions such as ischemic stroke, transient ischemic attacks, and optic nerve disorders. Registration in other countries has not followed. Most published clinical reports originate from a small number of Russian research groups, and independent replication outside that setting remains limited. The regulatory status therefore differs sharply between Russia and the rest of the world.
Laboratory work points toward modulation of neurotrophic signaling, particularly expression of brain-derived neurotrophic factor and nerve growth factor in hippocampal tissue. Studies also describe effects on monoamine turnover, inflammatory mediators, and oxidative markers. These observations come mainly from animal models and cultured cells, so the causal chain in humans is not firmly established. Whether the reported molecular changes translate into measurable clinical benefit is an open question. Reviews generally present the mechanism as plausible rather than demonstrated.
Clinical evidence consists largely of small trials with modest sample sizes, often without independent replication. Reported endpoints include cognitive scores, recovery after stroke, and visual function, but study designs vary widely and few trials meet contemporary reporting standards. Systematic reviewers have noted a high risk of bias in several of these reports. No large multicenter trial conducted outside Russia has been published. The compound is therefore best described as investigational in most jurisdictions, with its clinical role still unresolved.
The C-terminal Pro-Gly-Pro extension is not incidental. Proline-rich tails are known to resist several common peptidases, and the published literature attributes the longer half-life of Semax, relative to unmodified ACTH fragments, to this feature. The modification also removes the melanocyte-stimulating and corticosteroidogenic activity that characterizes longer ACTH-derived sequences. Because the molecule is small and hydrophilic, it is typically formulated as an aqueous solution for intranasal or parenteral delivery. Acetylation or amidation at the termini appears in closely related research peptides and shifts the mass by a fixed increment.
Reported pharmacological work centers on neurotrophic signaling, including changes in BDNF and NGF expression in hippocampal tissue in animal models. Human data come largely from studies conducted in Russia, and how well those results generalize to other populations remains an open question. Regulatory status differs sharply by jurisdiction: Semax is a registered prescription medicine in Russia, while it holds no approved marketing status in the United States or the European Union. Outside such jurisdictions it is generally handled as a research chemical, which affects both documentation and quality expectations.
Semax is a synthetic heptapeptide whose sequence is Met-Glu-His-Phe-Pro-Gly-Pro. It was developed as a fragment analog of adrenocorticotropic hormone, modeled specifically on the ACTH(4-10) region. The first four residues reproduce that fragment, while a Pro-Gly-Pro tripeptide is appended at the C-terminus. Work on the compound originated in Russia, where it entered clinical use as an intranasal preparation. Its sequence places it among short regulatory peptides studied for effects on the central nervous system rather than on the adrenal axis.
| Property | Value | Notes |
|---|---|---|
| Sequence | Met-Glu-His-Phe-Pro-Gly-Pro | Heptapeptide; ACTH(4-10) analog extended at C-terminus |
| Molecular mass | ~813.9 Da | Free peptide, unmodified |
| Appearance | White to off-white powder | Typical lyophilized solid |
| Solubility | Soluble in water and saline | Also soluble in common aqueous buffers |
| Storage (solid) | -20 °C, desiccated | Protect from moisture and repeated thawing |
各国监管态度分化明显。俄罗斯按处方药管理，部分东欧国家留有使用记录；欧盟与美国未批准其作为药物上市，市面流通品通常标注为研究用化学品。身份差异意味着标示含量、纯度与无菌性缺少统一核查。体育领域还牵涉反兴奋剂名录，跨境携带则受目的地药品法规约束。
Semax 是人工设计的七肽，序列为 Met-Glu-His-Phe-Pro-Gly-Pro，骨架取自促肾上腺皮质激素片段 ACTH(4-10)。它于二十世纪八十年代在苏联的分子遗传学研究机构内合成。设计目标是保留该片段与注意力和记忆相关的活性，同时剔除促皮质激素释放等内分泌作用。此后俄罗斯将其登记为药品并进入临床使用。
当时的短肽研究普遍关注能否穿越血脑屏障、在低剂量下产生中枢效应，Semax 属于这一路线。鼻内给药是其主要使用方式，俄语文献报道的适应症涵盖缺血性卒中、短暂性脑缺血发作、认知功能减退以及视神经病变。这些研究大多发表在当地期刊上，样本规模与终点设置同西方试验惯例存在差异，国际同行对其临床证据的强度看法不一。
== Management == Opioid use disorders typically require long-term treatment and care with the goal of reducing the person's risks and improving their long-term physical and psychological condition. First-line management involves the use of opioid replacement therapies, particularly methadone, naltrexone, morphine, hydromorphone, buprenorphine/naloxone (Suboxone), and diamorphine (heroin), which is the most effective treatment option of all drugs. Withdrawal management alone is strongly discouraged, because of its association with elevated risks of HIV and hepatitis C transmission, high rates of overdose deaths, and nearly universal relapse. This approach is seen as ineffective without plans for transition to long-term evidence-based addiction treatment, such as opioid agonist treatment. Though treatment reduces mortality rates, the first four weeks after treatment begins and the four weeks after treatment ceases are the riskiest times for drug-related deaths. These periods of increased vulnerability are significant because many of those in treatment leave programs during these periods. There is evidence that people with opioid use disorder who are dependent on pharmaceutical opioids may require a different management approach from those who take heroin.
== Side effects == Serious side effects are very rare. From 1998 to 2013, only one vaccine-related death was reported: an English child with pre-existent leukemia. On some occasions, severe reactions such as meningitis and pneumonia have been reported (mainly in inadvertently vaccinated immunocompromised children) as well as anaphylaxis. The possible mild side effects include redness, stiffness, and soreness at the injection site, as well as fever. A few people may develop a mild rash, which usually appears around the injection site. There is a short-term risk of developing herpes zoster (shingles) following vaccination. However, this risk is less than the risk due to a natural infection resulting in chickenpox. Most of the cases reported have been mild and have not been associated with serious complications. Approximately 5% of children who receive the vaccine develop a fever or rash. Adverse reaction reports for the period 1995 to 2005 found no deaths attributed to the vaccine despite approximately 55.7 million doses being delivered. Cases of vaccine-related chickenpox have been reported in patients with a weakened immune system, but no deaths. The literature contains several reports of adverse reactions following varicella vaccination, including vaccine-strain zoster in children and adults.
== Release == Library of Ruina was initially released for Windows via Steam's early access program on May 15, 2020, before being fully released for Windows and Xbox One on August 10, 2021. Versions for Nintendo Switch and PlayStation 4 were made available by publisher Arc System Works on April 25, 2024.
== Reliability == Across diverse conditions, researchers report relatively satisfactory reliability estimates for scores on the 14- and 10-item forms. For example, Roberti et al. (2006) reported reliability estimates of .85 and .82 in a university sample for scores on the perceived helplessness and perceived self-efficacy scales, respectively. Highly similar results were reported in Taylor (2015) in a sample of middle-aged adults. However, one of the limitations for much of the reliability estimates reported in the extant literature is the overly restrictive requirement of tau-equivalence for accurate reliability estimates. Tau-equivalence requires each item of a scale to have approximately the same size of relationship with the unobserved characteristic (e.g., perceived self-efficacy) driving responses to the items as well as consistent reliability regardless of the latent level driving the responses to the items. Therefore, it is largely unknown whether items on the PSS assign scores with the same degree of reliability for respondents with high latent levels (e.g., perceived helplessness) as respondents with low latent levels. One exception is in Taylor (2015), where the graded response model was utilized to study the reliability levels across levels of the two latent variables.
Sources: en.wikipedia.org
In Western countries, the most common motive for people practicing vegetarianism is health consciousness. The Academy of Nutrition and Dietetics has stated that at all stages of life, a properly planned vegetarian diet can be "healthful, nutritionally adequate, and may be beneficial in the prevention and treatment of certain diseases." Vegetarian diets offer lower levels of saturated fat, cholesterol and animal protein, and higher levels of carbohydrates, fibre, magnesium, potassium, folate, vitamins C and E, and phytochemicals.
=== Metformin === Reduced serum levels of vitamin B12 occur in up to 30% of people taking long-term anti-diabetic metformin. Deficiency does not develop if dietary intake of vitamin B12 is adequate or prophylactic B12 supplementation is given. If the deficiency is detected, metformin can be continued while the deficiency is corrected with B12 supplements.
Military forces in several countries, including France, the United States, and the United Kingdom, have used modafinil as an alternative to amphetamines for managing fatigue during combat operations and extended missions. The US Air Force approved modafinil for specific missions as a fatigue countermeasure. Modafinil is also available to astronauts aboard the International Space Station for fatigue management.
=== 28 February === The RSF launched a drone strike on the Merowe Power Station, leading to a power outage in the city. The JDF claimed to have intercepted an RSF supply shipment in North Darfur and "neutralized" foreign mercenaries, demanding apologies from Colombia. The claims were denied by the RSF.
Scarring during healing can create both physical and psychological problems, and is a significant clinical burden. Collagen, for instance, is abnormally organised in scar tissue; collagen in scars is arranged in parallel bundles of collagen fibers, whilst healthy scar free tissue has a "basket weave" structure (Figure 1). The difference in collagen arrangement along with a lack of difference in the dermal tissue when healing has taken place with or without scarring is indicative of regenerative failure of normal skin. Severe scarring resulting from these collagen deposits is known as hypertrophic scarring and is of great concern worldwide with an incidence ranging from 32–72%.
Sources: en.wikipedia.org
== Serological surveys == A 2016 research paper by Metcalf et al., amongst whom were Neil Ferguson and Jeremy Farrar, stated that serological surveys are often used by epidemiologists to determine the prevalence of a disease in a population. Such surveys are sometimes performed by random, anonymous sampling from samples taken for other medical tests or to assess the prevalence of antibodies of a specific organism or protective titre of antibodies in a population. Serological surveys are usually used to quantify the proportion of people or animals in a population positive for a specific antibody or the titre or concentrations of an antibody. These surveys are potentially the most direct and informative technique available to infer the dynamics of a population's susceptibility and level of immunity. The authors proposed a World Serology Bank (or serum bank) and foresaw "associated major methodological developments in serological testing, study design, and quantitative analysis, which could drive a step change in our understanding and optimum control of infectious diseases."
=== Human intervention === Humans have semi-domesticated several species of honey bee by taking advantage of their swarming stage. Swarming is the means by which new colonies are established when there is no longer space for expansion in the colony's present hive. The old queen lays eggs that will develop into new queens and then leads as many as half the colony to a site for a new hive. Bees generally swarm before a suitable location for another hive has been discovered by scouts sent out for this purpose. Until such a location is found the swarm will simply conglomerate near the former hive, often from tree branches. These swarms are unusually docile and amenable to transport by humans. When provided with a suitable nesting site, such as a commercial Langstroth hive, the swarm will readily form a new colony in artificial surroundings. These semi-domesticated colonies are then looked after by humans practicing apiculture or meliponiculture. Captured bees are encouraged to forage, often in agricultural settings such as orchards, where pollinators are highly valued. The honey, pollen, wax and resins the bees produce are all harvested by humans for a variety of uses. The term "semi-domesticated" is preferred because all bee colonies, even those in very large agricultural apiculture operations, readily leave the protection of humans in swarms that can establish successful wild colonies. Much of the effort in commercial beekeeping is dedicated to persuading a hive that is ready to swarm to produce more honeycomb in its present location.
=== Qigong === Qigong and Chinese medicine place huge emphasis on a form of energy called 精 (pinyin: jīng, also a morpheme denoting "essence" or "spirit") – which one attempts to develop and accumulate. "Jing" is sexual energy and is considered to dissipate with ejaculation, so masturbation is considered "energy suicide" amongst those who practice this art. According to Qigong theory, energy from many pathways/meridians becomes diverted and transfers itself to the sexual organs during sexual excitement. The ensuing orgasm and ejaculation will then finally expel the energy from the system completely. The Chinese proverb 一滴精，十滴血 (pinyin: yì dī jīng, shí dī xuè, literally: a drop of semen is equal to ten drops of blood) illustrates this point. The scientific term for semen in Chinese is 精液 (pinyin: jīng yè, literally: fluid of essence/jing) and the term for sperm is 精子 (pinyin: jīng zǐ, literally: basic element of essence/jing), two modern terms with classical referents.
=== China === The Government of China provides the funding for dialysis treatment. There is a challenge to reach everyone who needs dialysis treatment because of the unequal distribution of health care resources and dialysis centers. There are 395,121 individuals who receive hemodialysis or peritoneal dialysis in China per year. The percentage of the Chinese population with Chronic Kidney Disease is 10.8%. The Chinese Government is trying to increase the amount of peritoneal dialysis taking place to meet the needs of the nation's individuals with Chronic Kidney Disease.
Sources: en.wikipedia.org
Semax is a synthetic seven-amino-acid peptide derived from a fragment of corticotropin. It is used in Russia as a nasal preparation, while elsewhere it is studied as a research compound. It is not approved as a medicine in most countries.
Its sequence corresponds to the 4-10 region of corticotropin extended by three residues. This fragment lacks the region responsible for adrenal steroid release, so it is explored for neural rather than hormonal effects. The relationship explains the compound's classification among ACTH-derived peptides.
It holds approval in Russia for several neurological indications as a nasal spray or drop formulation. Regulatory agencies in the United States and the European Union have not approved it. Products sold elsewhere are generally labeled for research use only.
The sequence is Met-Glu-His-Phe-Pro-Gly-Pro, a seven-residue peptide. The first four residues correspond to the ACTH(4-10) fragment, and Pro-Gly-Pro is added at the C-terminus. N-acetylated versions also appear in the literature and differ in mass.